Herzschrittmachertherapie und Elektrophysiologie最新文献

{"title":"[Update of the ESC atrial fibrillation guidelines : From the DGK commission for clinical cardiovascular medicine].","authors":"Renate B Schnabel, Melanie Anuscha Gunawardene, Christian Andreas Perings, Daniel Steven, Hans-Jörg Busch, Isabel Deisenhofer, Karl Georg Häusler, Philipp Sommer, Ralf Birkemeyer, Lars Eckardt","doi":"10.1007/s00399-025-01096-4","DOIUrl":"https://doi.org/10.1007/s00399-025-01096-4","url":null,"abstract":"<p><p>In 2024, the current ESC guidelines for the management of atrial fibrillation (AF) were published. Despite significant advances in the prevention, diagnosis and treatment of AF, it remains the most common sustained arrhythmia with a significant impact on patients, their caregivers and public health. The concise guidelines focus on evidence-based recommendations and their practical implementation supported by clear figures and treatment pathways. The holistic care for AF patients including their comorbidities is prioritized in a comprehensive AF-CARE concept. It comprises \"C\" for comorbidities and risk factor management, \"A\" for avoidance of stroke and thromboembolism, \"R\" for reduction of symptoms by rate and rhythm control and \"E\", evaluation and dynamic reassessment. Ablation is now the first-line therapy in paroxysmal AF. Current data on device detected AF and triggered AF are considered. Maximum involvement of the patient for informed, shared decision-making is suggested, supported by the parallel publication of patient guidelines.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical device therapy in the paediatric population-age, indications, strategies and limitations.","authors":"Massimo Stefano Silvetti","doi":"10.1007/s00399-025-01091-9","DOIUrl":"https://doi.org/10.1007/s00399-025-01091-9","url":null,"abstract":"<p><strong>Background: </strong>Electrical device therapy is increasingly used for paediatric patients with congenital and acquired arrhythmias and heart diseases.</p><p><strong>Objectives: </strong>This review evaluates the indications, strategies and limitations of this therapy in the young. Pacing and defibrillation systems in young patients should last longer than in adults. The paediatric population ranges from preterm newborns to young adults, and therefore recommendations and pacing strategies are variable. Recent guidelines have provided new and updated recommendations. Various systems have enhanced our ability to treat arrhythmias. Transvenous and epicardial pacing systems compete for primacy among children; transvenous and subcutaneous defibrillators among adolescents. Outcomes are good, but there are frequent complications.</p><p><strong>Conclusion: </strong>Electrical device therapy in the paediatric population is effective and safe, but it needs to be adapted to the age, size, and pathophysiology patients.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sports or no sports? How to manage the young arrhythmia patient.","authors":"Ilger Ertugrul, Nico A Blom","doi":"10.1007/s00399-025-01089-3","DOIUrl":"https://doi.org/10.1007/s00399-025-01089-3","url":null,"abstract":"<p><strong>Background: </strong>Inherited arrhythmia syndromes and cardiomyopathies are among the most concerning causes of sudden cardiac death in young individuals, particularly in the context of physical activity. Historically, sports participation in these patients has been broadly restricted due to safety concerns. However, emerging data and updated guidelines suggest that a more individualized approach may be both appropriate and safe.</p><p><strong>Objectives: </strong>The aim of this study was to review current evidence and evolving recommendations regarding sports participation in young individuals with inherited cardiac diseases.</p><p><strong>Materials and methods: </strong>This review synthesizes recent studies, expert consensus statements, and current international guidelines (ESC, AHA/ACC).</p><p><strong>Results: </strong>Recent data indicate that, in selected patients with inherited arrhythmia syndromes and cardiomyopathies who have undergone thorough evaluation and counseling, participation in sports-under appropriate precautions-may be safe and well tolerated. Emerging studies report low incidence of adverse events in appropriately managed athletes. Guidelines have shifted away from blanket restrictions and towards shared decision-making, especially in asymptomatic individuals or those with controlled disease. Key factors include genotype-phenotype correlation, history of arrhythmic events, treatment adherence, and patient/family understanding of risks.</p><p><strong>Conclusion: </strong>In contrast to traditional dogma, a growing body of evidence supports less restrictive, patient-centered management for young individuals with inherited cardiac conditions. With proper evaluation, risk stratification, and informed decision-making, sports participation and leisure time activities may be possible-and even beneficial-for many of these patients.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual course of outflow tract tachycardia and cardiac decompensation in childhood: a case report and review of the literature.","authors":"Antonia Weymann, Julia Köbe, Julia Stegger, Julian Wolfes, Lars Eckardt, Matthias Sigler","doi":"10.1007/s00399-025-01090-w","DOIUrl":"https://doi.org/10.1007/s00399-025-01090-w","url":null,"abstract":"<p><p>Outflow tract tachycardia (OT) is the most common form of idiopathic ventricular tachycardia (VT) in children. It is usually an incidental finding and presents only with mild symptoms. If affected patients have impaired left ventricular (LV) function, recovery usually progresses quickly after termination of the VT. To the best of the authors' knowledge, this is the first description of a 9-year-old female patient who presented with incessant right ventricular OT and LV dysfunction that was initially assumed to be tachycardiomyopathy and later diagnosed to be related to underlying laminopathy. The VT was successfully treated by radiofrequency ablation, and electroanatomical mapping demonstrated no signs of endocardial scarring. The VT had most likely been present for a prolonged period since the patient and initially presented with only mild symptoms of cardiac congestion despite severely impaired LV function. It seems probable that the laminopathy somehow influenced the unusual course of impaired LV function in this patient, who had either idiopathic VT combined with incidentally proven laminopathy or, less likely, outflow tract VT related to the laminopathy mimicking idiopathic VT.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Modern WPW-syndrome treatment: from ECG via double-check-mapping to ablation].","authors":"Harilaos Bogossian, Nana-Yaw Bimpong-Buta, Sebastian Robl, Konstantinos Iliodromitis","doi":"10.1007/s00399-025-01093-7","DOIUrl":"https://doi.org/10.1007/s00399-025-01093-7","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Use of suture closure systems in interventional electrophysiology : Impact on workflows, resource utilization, reimbursement, and patient safety in hospitals in the STYLE AF study].","authors":"Sorin Ștefan Popescu, Christian Elsner, Noemi Kucharz, Valerie Zu Rhein, Clarissa Engewald, Kai Pardey, Roland Richard Tilz","doi":"10.1007/s00399-025-01095-5","DOIUrl":"https://doi.org/10.1007/s00399-025-01095-5","url":null,"abstract":"<p><strong>Background and objectives: </strong>Catheter ablation of cardiac arrhythmias is typically performed via femoral venous access. To reduce bleeding complications and shorten hospital stays, venous closure devices are gaining importance. This study aimed to quantitatively evaluate the impact of closure devices, \"tagesstationär\" (2 day-case stay with night leave) billing, and early recovery room (post-anesthesia care unit, PACU) discharge on economic indicators, patient-related outcomes, and staffing requirements.</p><p><strong>Methods: </strong>Based on data from the STYLE-AF study-including PACU length of stay, groin bleeding rates, and additional outcome parameters-supplemented by expert interviews and literature review, we conducted a simulation study and real-world implementation to analyze various scenarios: use of closure devices, \"tagesstationär\" discharge billing, early PACU discharge, and combinations thereof. Primary endpoints were time savings in the PACU, changes in groin bleeding probability, and gains in patient comfort quantified by quality-adjusted life years (QALYs).</p><p><strong>Results: </strong>The exclusive use of closure devices led to a 6.5% increase in case throughput and a gain of 0.0034 QALYs per patient. When combined with same-day discharge billing, the contribution margin increased by € 415 per case. Switching to same-day discharge billing without closure devices yielded a € 388.80 higher revenue per case but did not result in QALY gains or staff workload reductions. The most substantial effects were observed with the combined implementation of all measures: a 25% increase in case volume, € 661.27 higher contribution margin per patient, up to 24% relative reduction in PACU staff workload, and a QALY gain of 0.0034.</p><p><strong>Conclusion: </strong>Closure devices, particularly when integrated with process optimizations and \"tagesstationär\" discharge billing, provide significant multidimensional benefits across economic performance (contribution margin), resource efficiency (PACU time), and patient outcomes (QALYs through reduced groin bleeding)-contingent on institutional context and consistent implementation.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Compatibility of family and cardiac electrophysiology].","authors":"Johanna Müller-Leisse, Henrike A K Hillmann, David Duncker","doi":"10.1007/s00399-025-01092-8","DOIUrl":"https://doi.org/10.1007/s00399-025-01092-8","url":null,"abstract":"<p><p>Cardiac electrophysiology which includes device therapy and invasive cardiac electrophysiology is a growing interventional field within cardiology that has mostly been occupied by men but is increasingly attracting women. As the percentage of female physicians increases and as men share more family responsibilities, many young physicians are facing the question of whether a career in cardiac electrophysiology is compatible with family. Conditions allowing family-compatible working hours are met since electrophysiological procedures are usually elective. However, current structural conditions often require a high level of organization to realize well-scheduled working hours. The long training period also requires good organization, patience, and endurance. For a successful balance between career aspirations and family life in the field of cardiac electrophysiology, motivation and a willingness to compromise on the part of the employer and employee are often warranted. Employers and supervisors can further support employees with families by appreciating their efforts and by offering dedicated support programs and childcare on site. The ongoing scientific and social-political debate is crucial for the field of cardiac electrophysiology to become future-oriented and bring about long-term structural changes to promote young talent regardless of gender and family status.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Leitfaden zur sicheren und effektiven Vorhofflimmerablation mit Pulsed Field Ablation am Beispiel des pentaspline PFA-System.","authors":"Nico Reinsch, Victoria Johnson, Sascha Rolf, Sonia Busch, Micaela Ebert, Tilmann Maurer, Roland Tilz, Till Althoff, Julian Chun, David Duncker, Christian Heeger, Henning Jansen, Leon Iden, Andreas Rillig, Philipp Sommer, Tillman Dahme, Melanie Gunawardene, Heidi L Estner, Daniel Steven","doi":"10.1007/s00399-025-01087-5","DOIUrl":"https://doi.org/10.1007/s00399-025-01087-5","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rhythm therapy for congenital heart defects with implantable electronic devices].","authors":"Peter A Zartner","doi":"10.1007/s00399-025-01080-y","DOIUrl":"10.1007/s00399-025-01080-y","url":null,"abstract":"<p><p>Patients with congenital heart defects have an increased indication rate for pacemaker systems and implantable cardioverter defibrillators (ICD), which however are not designed for children. Therefore, the combination of selected materials is essential for long-term and safe therapy. Epimyocardial systems are the best option for neonates and infants, as well as patients with Fontan circulation who do not have systemic venous access to the heart. For most other patients, transvenous systems are advantageous because the leads and batteries last longer and are easier to adjust as the patient grows. To avoid vascular complications, only the thinnest leads should be used and broken leads should be explanted. Telemetric monitoring is urgently indicated for these patients in order to detect rhythm or system disturbances at an early stage.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"119-125"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Angiology in rhythmology: What should I know about vascular complications?]","authors":"Kristina Sonnenschein","doi":"10.1007/s00399-025-01067-9","DOIUrl":"10.1007/s00399-025-01067-9","url":null,"abstract":"<p><p>Both the performance of electrophysiological examinations and the implantation of cardiac devices (pacemakers, implantable cardioverter-defibrillator [ICDs], and cardiac resynchronization therapy defibrillator [CRT-D] systems) are associated with vascular punctures. This article provides an overview of possible vascular complications and their management from the perspective of angiology. The most common access site for invasive electrophysiological procedures is usually via the femoral veins and/or arteries. Puncture of the brachial vessels is a possible but rarely used alternative. For implantation of transvenous cardiac devices, access via the cephalic vein or axillary vein is used. The electrodes located in the venous vascular system represent a foreign material and increase the risk of thrombus formation in the affected vein. Punctures of the femoral vessels can lead to bleeding, thrombosis and the formation of arteriovenous fistulas or pseudoaneurysms (aneurysma spurium). Venous thromboses can occur postprocedurally. The correct puncture technique is essential to avoid complications. Ultrasound-guided puncture also significantly reduces the rate of vascular complications.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}